title: Treatment of Gartland type III pediatric supracondylar humerus fractures with the Kapandji technique in the prone position.
abstract: OBJECTIVE
  The purpose of this study was to report the efficacy of the Kapandji technique performed in the prone position for humeral supracondylar fractures in children.
  
  
  METHODS
  Retrospective.
  
  
  METHODS
  Level I trauma center.
  
  
  METHODS
  We retrospectively reviewed 34 children with Gartland type III supracondylar humerus fractures. There were 22 boys and 12 girls with a mean age of 5.2 years (range, 1-12.7 years).
  
  
  METHODS
  Closed reduction and the Kapandji technique were performed in the prone position for all patients. The mean follow-up was 17.4 months (range, 13.2-24.8 months).
  
  
  METHODS
  We assessed preoperative and postoperative radiographs to evaluate the quality of the reduction. The clinical outcome was assessed according to the criteria of Flynn.
  
  
  RESULTS
  All operations were performed in a closed manner, no cases required open reduction. Loss of reduction after K-wire fixation was identified in 2 patients. There were no pin-related nerve injuries. The mean range of elbow motion was 139.6 degrees. The clinical outcome was excellent in 31 patients, good in 2 patients (97% excellent or good), and fair in 1 patient.
  
  
  CONCLUSIONS
  This technique is an effective and safe option to treat type III supracondylar humerus fractures in children. In patients with severe soft tissue swelling, unstable fracture reduction, or unable to achieve acceptable reduction, this technique could facilitate fracture reduction and avoid unnecessary open reduction. The disadvantage of this technique is that the prone position is less desirable for airway management.
  
  
  METHODS
  Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Pediatric Orthopedics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Hsuan-Kai
authors.initials: HK
authors.lastname: Kao
authors.forename: Wen-E
authors.initials: WE
authors.lastname: Yang
authors.forename: Wei-Chun
authors.initials: WC
authors.lastname: Li
authors.forename: Chia-Hsieh
authors.initials: CH
authors.lastname: Chang
mesh_terms: D002648:Child; D002675:Child, Preschool; D004551:Elbow Joint / Q000601:surgery*; D005260:Female; D005592:Fracture Fixation / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D007223:Infant; D008297:Male; D016684:Prone Position; D012189:Retrospective Studies; D000092464:Elbow Injuries